Culturally-Protective Health Practices

ABSTRACT

Everyday pregnancy care may play an important role in explaining why Mexican immigrant women have positive birth outcomes despite relatively low incomes, low formal education levels, and lack of access to medical care. The paper is based on findings from a qualitative study utilizing in-depth ethnographically-in-formed interviews with 41 Mexican immigrant women in Chicago who had recently given birth. Results indicate that everyday pregnancy care guides maternal behaviors in pregnancy and has important effects on birth weight. Implications for the design of prenatal health care and social services for immigrant women are discussed.     

Teen mothers who are daughters of teen mothers: Psychological intergenerational dimensions of early motherhood

IntroductionResearchers have shown that being a daughter of a teenage mother is a risk factor regarding the possibility of having early, unprotected sexual intercourse and of falling pregnant. The experiences of young mothers in such situations and the aspects of intergenerational transmission in the mother–daughter relationship have not been well investigated.ObjectivesThis study analyses the experience of motherhood in young mothers (18–20 years at the time of the interview/15–16 at the time of their pregnancy) who are daughters of teen mothers themselves from the psychodynamic perspective of intergenerational transmission.MethodsSix young mothers from Southern Italy were selected and interviewed. A semi-structured interview was used to explore the early experience of pregnancy and motherhood and their relationship with their own mothers. The interviews were analysed through Interpretative Phenomenological Analysis (IPA).ResultsFive superordinate themes emerged: I didn't want, I didn't see and I didn't feel; Adolescence? I suddenly became a mother; History repeats itself again and again; Confused Spaces and How difficult is coming into the world?ConclusionAdolescent mothers, who themselves are daughters of teen mothers, seem to have difficulty in representing the meanings associated with their experience of pregnancy and motherhood. A lack of narrative transmission of the experience of pregnancy from mothers to daughters emerged. The implications for research and social policies will be discussed.     

Alcohol-Related Vehicular Death Rates for College Students in the Commonwealth of Virginia

Abstract

Objective: Determine rate of college student alcohol-related vehicular traffic fatalities in Virginia during 2007. Participants: Undergraduates at colleges and universities in Virginia. Methods: Institutions with membership in the American College Health Association were invited to participate in a survey. Data collected from institutional reports of student deaths due to vehicular accidents. Results: Twenty-four institutions were invited to participate. Sixteen responded (response rate = 67%), comprising total enrollment of 117,100 for 17- to 24-year-olds (56% of total college population in state). Five traffic deaths were reported, representing 4.3 deaths per 100,000 students. Based on statewide statistics that estimate alcohol contributes to 38.9% of traffic deaths, rate of alcohol-related motor vehicle deaths is 1.7 deaths per 100,000 college students in Virginia, which is 89% lower than leading national estimates. Conclusions: These findings suggest that past estimates of alcohol-related vehicular deaths among college students are overstated.     

Can we prevent deaths of homeless persons? Police led public health approach to prevent homeless deaths

Abstract

Research on homeless populations demonstrates that homelessness in itself is an independent risk factor for death. However, there is a dearth of detailed data on homeless decedents and the situations surrounding their deaths. This lack of knowledge, a desire to understand how and why homeless individuals were dying, and a sentinel event death led the Indianapolis Metropolitan Police Department Homelessness and Panhandling Unit to partner with a local researcher and begin conducting homeless death reviews. The approach is modeled after the evidence-based, public health approach of the Fetal and Infant Mortality Review process (FIMR). The FIMR model is a systematic approach to understanding system gaps and obtaining insights into the factors that resulted in homelessness and ultimately death. This article reports on the process to develop this unique multi-agency, police-led review of homeless deaths in Indianapolis, Indiana and resulting recommendations for action to decrease these deaths.     

Addressing Spiritual/Religious Issues in Therapy: Potential Problems and Complications

SUMMARY

Recent years have seen a strong interest on the part of mainstream mental health professionals in clients' religious/spiritual concerns. Several phenomena have contributed to this interest and encouraged psychotherapists to address such concerns in therapy. However, the therapist's own personal biases, lack of adequate education, personal discomfort and self-serving needs can contribute to problems and complications in therapy when addressing religious/spiritual issues, ten of which are described and discussed in this article.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

Consanguineous Marriage and Early Childhood Mortality in an Amish Settlement

Abstract

This paper examines the effect of inbreeding as a direct measure of consanguinity on early childhood mortality. Data are from a church directory of the Old Order Amish of the Lancaster, PA, settlement. The sample includes all infant deaths and a probability sample of survivors (total N = 1,823).

We find that inbreeding has a net positive effect on neonatal and infant deaths and on the instantaneous hazard rate. However, we also find socioeconomic and other explanations, even in this population, likely to experience certain genetically transmitted defects associated with infant mortality.     

Chapter 8: Responding to Deaths of Faculty,Staff and Students at UC,Berkeley

SUMMARY

This article describes an important initiative designed to address the deaths of faculty, staff, and students at the University of California at Berkeley. Work-life and EAP practitioners can play a significant role in reducing the distress and lost work time associated with workplace deaths by helping employers to plan a response to employee and client deaths, and by participating in implementing that response. A model framework is presented to demonstrate the vital need for coordination and integration among many of the employers' programs, services, and activities in order to address deaths.     

Diagnosis of Pregnancy

Abstract

Contraceptive failure is a growing problem, especially on the college campus. Because of this, college health care providers are treating more and more college women not only for pregnancy-related problems, but women that present to the health center with other health complaints and are pregnant as well.

For these reasons, the diagnosis of pregnancy must always be entertained by all health care providers treating young women. Pregnancy must always be excluded before any tests or procedures are done that may be teratogenic. This is not only important for optimal health care, but also for medical-legal reasons.

This paper presents four unusual presentations of pregnancy and reviews the guidelines for diagnosis of pregnancy.     

Daughter's Perceptions of Being Mothered by an Incest Survivor: A Phenomenological Study

ABSTRACT

This article presents the results of a qualitative analysis of the experience of being the daughter of an incest survivor using a phenomenological approach to the narratives of six women. The majority of the daughters identified a number of effects of their mother's abuse that they perceived as harmful as a child and that lasted into adulthood. Most perceived their mothers as failing to grow up. The daughters responded with a lack of affection toward their mothers, complications in differentiation and integration of a negative self-view. Even in adulthood, the daughters reported a number of characteristics that are normally associated with being a victim of sexual abuse, despite the fact that only two of the six had been so abused. The mother's ultimate disclosure of her incest history helped the daughter to offset these difficulties. The clinical implications of these findings are outlined.     

Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.     

Perceived Built Environment Characteristics of On-Campus and Off-Campus Neighborhoods Associated With Physical Activity of College Students

Abstract

Objective: To identify differences in neighborhood environment and their association with physical activity (PA) levels of on-campus compared with off-campus students. Participants: Participants were 822 undergraduate students at a mid-sized mid-Atlantic university. Methods: Students completed the Neighborhood Environment Walkability Scale–Abbreviated and the International Physical Activity Questionnaire in October 2013. Results: Lower residential density, traffic safety, and crime scores and higher land-use mix diversity, aesthetics, and lack of parking scores were reported among on-campus residents. On-campus residents reported higher levels of active transportation PA, leisure PA, and total PA. Land-use mix diversity, aesthetics, and lack of cul-de-sacs were associated with physical activity level. Conclusion: The on-campus and off-campus environments differ in ways that may impact the ability of undergraduate students to be physically active. Strategies to promote continued active transportation and leisure PA are discussed.     

The Process of Problem Pregnancy Counseling

Abstract

Effective counseling for women experiencing an unwanted pregnancy can facilitate quality decision making and personal growth. Supportive counseling minimizes the trauma and the potential for emotional deterioration. Timely counseling augments a woman's coping ability with this current life crisis and provides her with a positive, growth-producing experience. A counseling process to accomplish these objectives is described. The concepts of crisis theory and active decision making are applied to the pertinent social, emotional, and medical ramifications of pregnancy, parenthood, and abortion. Subjective reporting and clinical experience indicate that women receiving such counseling are better able to deal with and resolve the crisis of unwanted pregnancy.     

Sexual health programming for vulnerable youth: Improving knowledge,attitudes, and behaviors

PurposeAmong girls in foster care, 48% become pregnant at least once by age 19 (Dworsky & Courtney, 2010). Youth in or at-risk for foster care (YFC) report limited knowledge about, access to, and use of condoms; ambivalent attitudes towards teen parenting; and participation in other risky behaviors. For the current study, we adapted and supplemented an evidence-based sexual health program called SiHLE, using a systematic adaptation framework (ADAPT-ITT, Wingood & DiClemete, 2008), to address the unique and targeted needs of youth living in a temporary shelter due to lack of housing. Youth in this study were either in foster care and awaiting placement, or having serious family problems and were at-risk of entering the foster care system.MethodsThirty-six youth participated in SiHLE-YFC during their stay at a temporary shelter. Four 90-minute sessions focused on increasing sexual health knowledge, improving attitudes towards and self-efficacy of condom use, and developing core skills such as problem-solving and communication.ResultsAs hypothesized, youth showed high satisfaction with the intervention and significant improvement in sexual health knowledge from pre to post. At one-month follow-up, youth continued to show significant improvement in sexual health knowledge, along with a significant reduction in risky sexual behaviors. Though not significant, there were moderate effect sizes for changes in attitudes towards teen pregnancy and condoms. There were no changes in attitudes towards teen parenting.ConclusionTaken together, findings suggest that sexual health education directly targeting the unique needs of YFC may improve sexual health knowledge and behavior, and are discussed in the context of challenges associated with intervention and research with this population.     

Adoption in the Media

Abstract

This is a review of three articles that appeared in the popular print media in 1996. All cover the subject of teen pregnancy. Two are written by or about birth parents and their decision to plan adoption. The other article focuses on the life of two teenagers who will parent their children.     

Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas

Objective: To identify preferences for and use of short-acting hormonal (e.g., oral contraceptives, injectable contraception) or long-acting reversible contraception (LARC) among community college students in Texas. Participants: Female community college students, ages 18 to 24, at risk of pregnancy, sampled in Fall 2014 or Spring 2015 (N = 966). Methods: We assessed characteristics associated with preference for and use of short-acting hormonal or LARC methods (i.e., more-effective contraception). Results: 47% preferred short-acting hormonal methods and 21% preferred LARC, compared to 21% and 9%, respectively, who used these methods. A total of 63% of condom and withdrawal users and 78% of nonusers preferred a more effective method. Many noted cost and insurance barriers as reasons for not using their preferred more-effective method. Conclusions: Many young women in this sample who relied on less-effective methods preferred to use more-effective contraception. Reducing barriers could lead to higher uptake in this population at high risk of unintended pregnancy.     

Experiences of adolescent mothers in Costa Rica and the role of parental support

ABSTRACT

Adolescent pregnancy is often thought of as a social problem, one that can cause the adolescent mother hardship, including poverty, low-educational attainment, and housing instability. Although much research has been conducted about adolescent pregnancy in the developed world, less has considered adolescent pregnancy in the developing world. This qualitative study focuses on women who were impoverished in Costa Rica who had been pregnant in adolescence. The goal of the study was to gain a better understanding of the lived experiences of the mothers, as well as the kinds of support they received during and after the pregnancy. The research sample consisted of 22 female participants who were impoverished and had experienced an unintended pregnancy in adolescence. The key finding from this study was that parental support was the most important factor in mitigating adolescent experiences of stress and negative feelings about their choices related to the pregnancy. The study has implications for the understanding of the experiences of women who are vulnerable with respect to adolescent pregnancies in Latin America and for Latina migrants to the United States.     

The Reparative Motive in Surrogate Mothers

ABSTRACT

This paper explores the motivations of surrogate mothers, with a focus on the underlying reparative motive. An overview of the typical surrogate's characteristics and personality, the theoretical underpinnings of the reparative motive, and the tension between reparation and loss in the surrogate are considered. Clinical material from psychological evaluations of women pursuing a surrogate pregnancy is presented to illustrate.